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Utah rates for HCPCS 65855

Trabeculoplasty by laser surgery

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $524.81 / $4,466.84
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$977.24 / $977.24 / $977.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $302.00 / $602.56
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$416.87 / $912.01 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $338.84 / $478.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $407.38
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $977.24 / $2,238.72
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,258.93 / $1,479.11 / $3,388.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $407.38 / $707.95
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $338.84 / $616.60
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $295.12 / $426.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $2,818.38 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $275.42 / $416.87